Cognitive impairment and partnership status in the United States, 1998–2016, by sex, race/ethnicity, and education

Abstract

Cognitively impaired adults without a partner are highly disadvantaged, as partners constitute an important source of caregiving and emotional support. With the application of innovative multistate models to the Health and Retirement Study, this paper is the first to estimate joint expectancies of cognitive and partnership status at age 50 by sex, race/ethnicity, and education in the United States. We find that women live a decade longer unpartnered than men. Women are also disadvantaged as they experience three more years as both cognitively impaired and unpartnered than men. Black women live over twice as long as cognitively impaired and unpartnered compared with White women. Lower-educated men and women live around three and five years longer, respectively, as cognitively impaired and unpartnered than more highly educated men and women. This study addresses a novel facet of partnership and cognitive status dynamics and examines their variations by key socio-demographic factors.

Keywords:

• cognitive impairment
• partnership status
• multistate model
• cognitive health expectancies
• partnership expectancies
• health disparities
• longitudinal analysis

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Please direct all correspondence to Shubhankar Sharma, University of St Andrews, Irvine Building, North Street, KY16 9AL, St Andrews, Scotland; or by Email: [email protected].

2 Funding: Shubhankar Sharma holds a St Andrews—Max Planck PhD Scholarship in Population Health. He gratefully acknowledges funding from the Max Planck Institute for Demographic Research, the University of St Andrews, and the resources made available by the International Max Planck Research School for Population, Health and Data Science. Hill Kulu received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No. 834103). His research was also supported by Economic and Social Research Council grant ES/K007394/1 (ESRC Centre for Population Change). Mikko Myrskylä was supported by the ERC Synergy Grant to BIOSFER (No. 101071773) and the Strategic Research Council (SRC) grant to FLUX Consortium, decision numbers 345130 and 345131.

3 Author contributions: All the authors contributed to the conception and design of the study and had access to the secondary data source. Shubhankar Sharma performed the analyses and wrote the first draft. All authors interpreted the results and revised earlier versions of the paper critically for important intellectual content and approved the final version to be published.

4 Sponsors had no role in the design, methods, subject recruitment, data collections, analysis, and preparation of the paper.